The Centers for Medicare and Medicaid Services (CMS) has submitted a 653-page finalized rule governing Medicaid managed care to the Office of Management and Budget (OMB) for review, according to Modern Healthcare. Reports indicate that the rule will take a step to reduce the institution for mental diseases (IMD) prohibition on treating adult Medicaid patients in freestanding psychiatric hospitals by permitting states to pay managed care organizations (MCOs) for behavioral care to beneficiaries who stay 15 days or less in an IMD. Additionally, the rule is reported to contain a medical loss ratio of at least 85%, which would allow 15% to be paid to MCOs for administration, marketing and profit. The rule also contains requirements for improving network adequacy through time and distance standards for certain types of providers, including hospitals and physicians.

OMB can take up to 90 days to review the rule, therefore, it could be published sometime in May. KHA’s comments were among the 900 comment letters CMS received on proposed rule....

The Centers for Medicare and Medicaid Services (CMS) has issued a
final rule that will update the payment rates used under the prospective
payment system (PPS) for skilled nursing facilities (SNFs) for fiscal year
(FY) 2015.

In addition, CMS has issued a
final rule to update the Medicare Inpatient Psychiatric Facilities (IPFs) PPS for FY 2015.
The rule is scheduled to be published in the August 6 Federal
Register. A copy can currently be downloaded at http://www.ofr.gov/OFRUpload/OFRData/2014-18329_PI.pdf.This link will change upon publication later this week.